Open Access2053. Information Gaps Among Patients Prescribed Antibiotics on Discharge to Nursing Homes
Author(s) -
Jon P. Furuno,
Brie N. Noble,
Bo Weber,
Vicki Nordby,
Jessina C. McGregor,
David T. Bearden,
Daniel Chan,
Jennifer Tjia,
Christopher Crnich
Publication year - 2019
Publication title -
open forum infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.546
H-Index - 35
ISSN - 2328-8957
DOI - 10.1093/ofid/ofz360.1733
Subject(s) - medicine , medical prescription , antibiotics , antimicrobial stewardship , medical record , acute care , psychological intervention , pediatrics , emergency medicine , family medicine , antibiotic resistance , nursing , health care , microbiology and biotechnology , biology , economics , economic growth
Background Antibiotic use in nursing homes (NHs) is frequently initiated in acute care hospitals. Comprehensive antibiotic administration instructions are critical to inform antimicrobial stewardship efforts in NHs. However; little is known about the quality of discharge communication for residents transitioning from hospitals to NHs with an antibiotic prescription. Methods We reviewed hospital discharge summaries from a 10% random sample of hospital-initiated antibiotic prescriptions among residents of 17 for-profit NHs in Oregon, California, and Nevada admitted between January 1 and December 31, 2017. Data elements of interest were documentation of antibiotic choice, indication, instructions, and pending microbiology tests. Results Among 217 hospital-initiated antibiotic prescriptions, mean (standard deviation) age was 64 (29) years and 57% were female. The most frequently prescribed hospital-initiated antibiotics were cephalosporins (36%), fluoroquinolones (16%), and penicillins (14%). Hospital discharge summaries were missing from 19% (42/217) of the resident medical records. Core antibiotic prescribing information was missing from 38% (67/175) of the medical records with a discharge summary: 11% (20/175) were missing all core elements, 23% (41/175) were missing the antibiotic indication, 27% (48/175) were missing antibiotic dose, 27% (48/175) were missing antibiotic frequency, and 32% (56/175) were missing antibiotic duration. Parental antibiotics were more frequently missing information compared with oral antibiotic prescriptions (45% vs. 37%, P = 0.32). Conclusion Information gaps around antibiotic prescriptions are prevalent in transfer documentation for NH residents admitted from acute care hospitals. Interventions are needed to improve the quality of information transferred from acute care hospitals to NHs. Disclosures All authors: No reported disclosures.